Carmustine
Class: Antineoplastic Agents
- Alkylating Agents
VA Class: AN100
CAS Number: 154-93-8
Brands: BiCNU, Gliadel Wafer
Warning
- Warning Information for IV Carmustine
Use under supervision of a qualified clinician experienced in therapy with antineoplastic agents.
Risk of bone marrow suppression (e.g., thrombocytopenia, leukopenia), resulting in bleeding and infection. Bone marrow toxicity is delayed and cumulative. Monitor CBCs weekly during and for at least 6 weeks following each dose; do not administer more frequently than every 6 weeks. Adjust subsequent dosages based on nadir blood counts from previous dose. (See Dosage Modification for Toxicity under Dosage and Administration.)
Risk of dose-related pulmonary toxicity. Cumulative doses >1400 mg/m2 associated with substantially greater risk. Delayed pulmonary toxicity can occur years after treatment and result in death, particularly in patients treated during childhood.
Introduction
Antineoplastic agent; a nitrosourea-derivative alkylating agent.
Uses for Carmustine
Brain Tumors: Conventional Chemotherapy
Adjunct to radiation therapy following surgery for palliative treatment of malignant glioma (i.e., astrocytoma, ependymoma, medulloblastoma, brainstem glioma) and metastatic brain tumors.
Among several preferred chemotherapeutic regimens for anaplastic astrocytoma and glioblastoma multiforme. Has not been shown to increase survival time, but a trend toward a higher long-term survival rate (e.g., at 18 months) has been observed.
Adjuvant or salvage therapy for oligodendroglioma.
Surgery with or without radiation therapy currently considered standard treatment for ependymoma and medulloblastoma. Radiation therapy considered standard treatment for brainstem glioma.
Brain Tumors: Intracranial Wafer Implant
Adjunct to surgery and radiation for treatment of newly diagnosed high-grade malignant glioma. Among several preferred chemotherapeutic regimens for anaplastic astrocytoma and glioblastoma multiforme.
Adjunct to surgery for treatment of recurrent glioblastoma multiforme.
Multiple Myeloma
Carmustine-containing regimens considered alternative therapy for palliative treatment of multiple myeloma.
Hodgkin’s Disease
Used in combination with other agents as secondary therapy for treatment of refractory or relapsed Hodgkin’s disease.
Combination regimens containing other agents currently are preferred as initial or alternative therapy for this cancer.
Non-Hodgkin’s Lymphoma
Used in combination with other agents as secondary therapy for treatment of refractory or relapsed non-Hodgkin’s lymphomas.
Combination regimens containing other agents currently are preferred as initial or alternative therapy for these cancers.
Melanoma
Has been used alone or in combination therapy for palliative treatment of metastatic melanoma†; however, low response rate and substantial toxicity limit this use of carmustine.
